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PO BOX 10066 Augusta Georgia 30999-0001 www. PalmettoGBA. com/RR ISO 9001 RAILROAD MEDICARE - RRB SPECIALTY MAC Request for Railroad Medicare PTAN for Electronic Submitters This form is for electronic claim submitters only. Please enter your information into this form prior to pressing the PRINT button. Any forms printed blank and then handwritten will cause processing delays. Provider s must have provided a service s to a Railroad Medicare benef....

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